【摘要】目的探讨乳腺囊性肿块的临床特点及诊治经验。方法对我院1988年4月至2003年5月期间收治的220例乳腺囊性肿块患者的临床资料进行回顾性分析。结果经均手术切除及病理学检查，本组病例中乳腺囊性上皮增生症162例，积乳性乳腺囊肿26例，单纯性乳腺囊肿23例，乳腺叶状囊肉瘤5例，大导管内乳头状瘤4例。结论乳腺囊性肿块具有一定的共性和个性特点，术前B超检查和诊断性穿刺对乳腺囊性肿块的诊断和鉴别诊断有一定价值，但确诊有赖于病理学检查，手术可以明确诊断和治愈疾病。
目的 全面介绍先天性囊性腺瘤样畸形(CCAM)其可能的病因，临床、病理特点及诊断手段，循证探讨针对CCAM的治疗方法及预后。 方法 对我院2011年11月收治的1例罕见的CCAM患者的临床资料进行分析，并对相关文献进行复习。 结果 患者数次误诊后最终诊断为CCAM，予手术治疗后痊愈，随访1年无复发。 结论 CCAM是一种少见的、非遗传性的、错构瘤样的肺发育异常，为一种良性的肺部畸形，其特点是局部肺终末呼吸性细支气管过度生长。CCAM多通过产前影像学检查、活组织检查或术后病检诊断。手术为治愈该病的最根本、最重要措施。
ObjectivesTo systematically review the efficacy and safety of ciprofloxacin for non-cystic fibrosis bronchiectasis.MethodsDatabases including PubMed, EMbase, The Cochrane Library, CBM, VIP, CNKI and WanFang Data were electronically searched from inception to August 2018 to collect randomized controlled trials (RCTs) on ciprofloxacin in the treatment of non-cystic fibrosis bronchiectasis. Two reviewers independently screened literature, extracted data, and assessed risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 9 RCTs involving 1 666 patients were included. The results of meta-analysis showed that: compared with control group, the ciprofloxacin more efficiently eradicate bacteria from sputum (RR=4.34, 95%CI 2.04 to 9.23, P=0.000 1), decrease risk of the exacerbations (RR=0.81, 95%CI 0.71 to 0.93, P=0.002) and the mean bacterial load (MD=–4.08, 95%CI –6.29 to –1.87, P=0.001). However, there were no significant differences between two groups in clinical efficiency and adverse events.ConclusionsThe current evidence shows that, ciprofloxacin can decrease the mean bacterial load and risk of the exacerbation, and more efficiently eradicate bacteria from sputum in non-cystic fibrosis bronchiectasis patients. Due to limited quality and quantity of the included studies, more studies are required to verify the conclusions.
目的 探讨腹膜后囊性淋巴管瘤的CT诊断价值和治疗方法。方法 回顾性分析2004年6月至2010年5月期间我院收治的5例经病理检查证实的腹膜后囊性淋巴管瘤患者的临床表现、CT影像特征、手术治疗及术后随访的资料。结果 5例患者术前CT均诊断为囊性淋巴管瘤，均行手术完整切除肿瘤，术后病理结果均证实为囊性淋巴管瘤。术后7 d顺利出院，随访3个月～6年均无复发。结论 CT对腹膜后囊性淋巴管瘤的诊断具有重要意义，手术完整切除整个囊壁是治疗及预防术后复发的最好方法。
Fibropolycystic liver diseases (FLDs) is a rare genetic disorder, including bile duct hamartomas, congenital hepatic fibrosis, polycystic liver disease, Caroli’s disease, and choledochal cysts. Fibropolycystic liver diseases has received little clinical attention and exhibits a variety of imaging manifestations, leading to a high likelihood of missed diagnosis and misdiagnosis. Through this case, we delineate the characteristic imaging manifestations of the disease and its underlying pathological mechanisms. Our objective is to enhance readers' comprehension of the disease and thereby reduce the rate of missed diagnosis and misdiagnosis of the disease.
目的 评价不同外科手术治疗肝脏囊性占位的临床疗效以及不同外科治疗策略的优缺点。 方法 对1998年1月－2011年12月收治的肝囊性占位患者的临床资料进行回顾性分析。共纳入148例患者，其中单纯性肝囊肿患者86例（单发35例，多发51例），多囊肝病患者62例。43.9%（65/148）患者行腹腔镜囊肿开窗治疗，27.0%（40/148）患者行开腹囊肿开窗术，21.6%（32/148）的患者行经皮囊肿穿刺及硬化剂注入术，另有7.4%（11/148）患者行开腹肝部分切除联合囊肿开窗术。 结果 经过手术治疗后，患者症状缓解率高达100.0%；术中患者出血量以经皮囊肿穿刺及硬化剂注入术最少，而以开腹肝部分切除联合囊肿开窗术最多。对于单纯性肝囊肿单发患者，不同手术治疗后均未出现症状复发；对于单纯性肝囊肿多发患者，肝部分切除联合囊肿开窗术治疗未出现症状复发，而经皮囊肿穿刺及硬化剂注入、腹腔镜囊肿开窗和开腹囊肿开窗治疗则分别有3、4、2例患者发生症状或影像学复发，总复发率为17.6%(9/51)；对于多囊肝病患者，经皮囊肿穿刺及硬化剂注入、腹腔镜囊肿开窗、开腹开窗和肝部分切除联合囊肿开窗治疗则分别有2、7、3和2例患者发生症状或影像学复发，总复发率为22.6%（14/62）。 结论 目前常用治疗方式对于单纯性肝囊肿单发患者疗效均理想，但对于单纯性多发肝囊肿和多囊肝病患者远期效果均尚不理想。
目的 提高对囊性纤维化的认识。 方法 2011年11月收治1例自幼有临床表现的囊性纤维化患者，回顾其诊断及治疗经过，复习相关文献总结其临床特征、诊疗进展及预后评价。 结果 囊性纤维化起病年龄较早，患者自幼年起即反复出现肺、消化道、肝脏等多系统病变，最终导致多器官功能衰竭。 结论 应提高对囊性纤维化的识别度，对于发病年龄过早、反复发作的严重支气管扩张，伴随生长发育延迟、肝硬化等临床征象应注意对囊性纤维化的筛查。
ObjectiveTo review the current clinical application of Beger procedure and Frey procedure for benign disease or low-grade malignant potential lesion of pancreas. MethodsRelevant literatures about current advance of clinical application of Beger procedure and Frey procedure published recently of domestic and abroad were collected and reviewed. ResultsWith the concept of organ-preserving operations was adopted in recent years, Beger procedure and Frey procedure were applied generally. Beger procedure and Frey procedure were associated with tolerable perioperative risk, postoperative complications, and good outcomes in the aspects of preservation of function and curability in these lesions compared to conventional pancreatectomy, with preservation of the physiological food passage, thus patients gained weight faster, had less pain, and demonstrated better exocrine and endocrine pancreatic function postoperatively and an improvement in the quality of life. Both procedures had reached an international position as a standard operation for the treatment of benign disease or low-grade malignant potential lesion of pancreas. But after long-term following-up early advantages were no longer present. ConclusionsBeger procedure and Frey procedure are safe and effective in providing good outcomes in the aspects of preservation of function and curability in benign disease or low-grade malignant potential lesion of pancreas. Organ-preserving pancreatectomy could become a new organ-preserving standard operation.